Journal Article > LetterFull Text
Int J Tuberc Lung Dis. 1 June 2012; Volume 16 (Issue 8); 1129-1130.; DOI:10.5588/ijtld.12.0370-2
Zachariah R, Edginton ME, Srinath S
Int J Tuberc Lung Dis. 1 June 2012; Volume 16 (Issue 8); 1129-1130.; DOI:10.5588/ijtld.12.0370-2
Journal Article > CommentaryFull Text
Int J Tuberc Lung Dis. 16 June 2012 (Issue 6)
Zachariah R, Harries AD, Srinath S, Ram S, Viney K, et al.
Int J Tuberc Lung Dis. 16 June 2012 (Issue 6)
The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control' be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm.
Journal Article > ResearchFull Text
Int J Tuberc Lung Dis. 1 November 2011; Volume 15 (Issue 11); DOI:10.5588/ijtld.11.0316
Zachariah R, Reid AJ, Srinath S, Chakaya JM, Legins K, et al.
Int J Tuberc Lung Dis. 1 November 2011; Volume 15 (Issue 11); DOI:10.5588/ijtld.11.0316
Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.
Journal Article > LetterFull Text
Int J Tuberc Lung Dis. 1 August 2012; Volume 16 (Issue 8); 1129-30.; DOI:10.5588/ijtld.12.0370-2
Zachariah R, Srinath S, Edginton ME
Int J Tuberc Lung Dis. 1 August 2012; Volume 16 (Issue 8); 1129-30.; DOI:10.5588/ijtld.12.0370-2